The Implementation of a Quality Council in a Surgical Trauma ICU and Its Impact on Ventilator Days

Introduction: At our institution, a quality council was implemented in August of 2024 to develop interdisciplinary interventions that sought to improve various patient outcomes in the surgical trauma ICU. Since its implementation, this council has developed multiple standardized protocols for both nursing and provider teams that focus on common aspects of patient care. These include a protocol named FASTHUGS BID, used during interdisciplinary rounds to summarize important patient information including feeding plans, analgesic regimens, thromboprophylaxis, ventilator settings, and glycemic control, among others. The council also implemented a Critical Event Debriefing protocol to expand the preexisting protocol that only applied to code events, to all critical events.


Methods: Since April of 2024, all patients admitted to the surgical trauma ICU have been tracked, and various outcome measures have been charted into a secure and deidentified. For our analysis, patients who were mechanically ventilated were selected from this database, and data on the number of ventilator days was compiled, defined as time from intubation to extubation. A monthly average was subsequently calculated, and an unpaired t-test was done to describe any significant differences in monthly averages from before and after the establishment of the quality council.


Results: In the 4 months prior to the implementation of the quality council, there were a total of 137 patients who underwent mechanical ventilation, with an average of 4.4 ventilator days. From August 2024 to July 2025, there was a total of 437 mechanically ventilated patients, with an average of 3.3 ventilator days. There was a statistically significant difference between these two values, with a p=0.034.


Conclusions: Integration of standardized protocols within interdisciplinary ICU teams is important to adequately address the wide range of medical issues patients are treated for. This analysis showed our institutions’ successful attempt at decreasing an important marker of ICU care quality, ventilator days, through some of these protocols. This quality council continues to implement changes to ICU protocols in hopes of minimizing other adverse ICU outcomes, including delirium and self-extubation, that we hope to analyze in future studies.